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This is VAERS ID 1417970

History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1417970
VAERS Form:2
Age:13.0
Sex:Female
Location:New York
Vaccinated:2021-06-19
Onset:2021-06-20
Submitted:0000-00-00
Entered:2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 - / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Pain, Rash, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt had body aches, then back from shoulder blades to waist broke out in hives. Mom applied ice. Called Dr''s Office. Ice and ibuprofen given throughout day as needed. Hives eventually decreased, left w rash, that too had faded by night time.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1417970&WAYBACKHISTORY=ON


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